title: Breast cancer screening among southwest American Indian women living on-reservation.
abstract: BACKGROUND
  One- and five-year breast cancer survival rates are significantly lower among Southwest American Indian (AI) women compared with non-Hispanic whites, primarily due to late stage at diagnosis. By detecting cancers at an earlier stage, screening mammography can reduce breast cancer mortality by 30% among women ages 50-69 years.
  
  
  METHODS
  To determine rate of and predictors of participation in breast cancer screening services among Southwest AI women, randomly selected AI women living on the Arizona Hopi reservation were interviewed. Independent predictors of breast cancer screening were determined using logistic regression analyses among respondents ages > or = 40 years (n = 314).
  
  
  RESULTS
  Of respondents > or = 40 years, 26.4% had had a mammogram in the past 2 years, and 23.2% of women > or = 50 years had had both a mammogram and a clinical breast examination. Mammography screening in the past 2 years was independently associated with an age between 50 and 59 years, knowledge of the procedure, belief that mammography can detect breast cancer, having yearly Pap smears, and use of the Hopi-language.
  
  
  CONCLUSIONS
  Self-reported breast cancer screening rates among this population of AI women are far below objectives set for the Year 2000. This study confirms the importance of breast cancer screening knowledge and participation in routine medical services to rates of breast cancer screening.
authors.affiliation: Arizona Prevention Center, University of Arizona, Tucson 85721, USA.
authors.forename: A
authors.initials: A
authors.lastname: Giuliano
authors.forename: M
authors.initials: M
authors.lastname: Papenfuss
authors.forename: J
authors.initials: J
authors.lastname: de Guernsey de Zapien
authors.forename: S
authors.initials: S
authors.lastname: Tilousi
authors.forename: L
authors.initials: L
authors.lastname: Nuvayestewa
mesh_terms: D000328:Adult; D000368:Aged; D001130:Arizona / Q000453:epidemiology; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality; D005260:Female; D015438:Health Behavior; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D012044:Regression Analysis; D015996:Survival Rate; D014481:United States; D016549:United States Indian Health Service; D016387:Women's Health